On Maharashtra's Blood Bag QR Mandate, Industry Veteran Sankalp Warns: Real Traceability Means Vein-to-Vein, Not Just Bag-to-Bank
By Arunima Rajan
Sankalp India Foundation has worked with blood banks, patients, donors, and hospitals for over two decades. Through Jagriti InnoHealth Platforms Pvt. Ltd., their healthcare technology partner, Sankalp also built and implemented blood banking technology since 2011. The foundation has seen both the promise of digitisation and the realities of adoption in a highly regulated, high-pressure environment. In an interview with Arunima Rajan, Rajat Agarwal, President, Sankalp India Foundation, says that a sustainable system must be vein-to-vein, from donor to patient.
Sankalp has built and run blood inventory technology for years. What does it actually take to track a blood unit reliably from donation to transfusion, and where do most blood banks fall short?
Reliable tracking requires the complete workflow to be digitally enabled, from donor registration, collection, testing, component preparation, inventory, issue, transport, receipt, and final transfusion. Technology works only when it helps the last-mile user. In our experience, adoption is sustained when the system makes daily work easier, more accurate, and more transparent. If technology is introduced only as an additional compliance layer, adoption remains partial and temporary. The biggest challenge is fragmentation. Blood banks are often asked to comply with different reporting formats, portals, standards, and requirements that are not integrated with existing systems. This creates duplication and weakens adoption. The most reliable systems are workflow-integrated, standards-driven, and useful to the operator, not merely imposed on the operator.
Maharashtra is promising a QR code on every blood bag. From your experience, what will decide whether this works: the technology, the data entry discipline, or enforcement?
End-to-end traceability is central to blood banking. The intent is correct. The key question is whether the proposed QR code mechanism has been validated as the right solution for the problem that has surfaced. Moving from the discovery of a problem in one inspection to a statewide mandate is a major step. Before that, the intervention must be tested and shown to address the actual failure. Only then will it be clear whether the gap is in technology, data entry discipline, enforcement, or hospital-side processes. Traceability cannot stop at the blood bank. The chain must continue at the hospital end, where the blood component is received, stored, assigned, and transfused.
A sustainable system must be vein-to-vein,from donor to patient.
e-RaktKosh was built precisely for national blood bank digitisation, yet adoption remains patchy. Why has it not delivered, and does a state building its own QR system solve the problem or duplicate it?
Any large digital intervention must prove outcomes in real-world conditions. Without that, even a well-intended system can become another compliance burden in an already regulation-heavy sector. The larger question is alignment. A state-level system must fit with national policy, national digital health architecture, global standards, and the information systems already used by blood banks. States can and should innovate. But innovation should strengthen the ecosystem, not create another silo. A new system should integrate with existing platforms, follow accepted standards, and reduce duplication for blood banks
Blood moving informally between blood banks, as alleged at JJ Mahanagar, is exactly what traceability systems should catch. How common is this in your experience, and what would a system that genuinely catches it look like?
The first question is whether systems to prevent this did not exist, or whether existing systems were bypassed. These are different problems. If there was no adequate system, stronger systems are needed. If systems existed but were not followed, the issue is compliance, enforcement, and accountability. In that case, making technology more sophisticated for everyone may not be the only answer. A genuine traceability system must record every unit from collection to final transfusion. It should capture every transfer, who authorized it, where the unit physically moved, and whether what was issued was actually received and transfused. It must also include the hospital side of the chain. Digitisation is valuable because it strengthens audits, inspections, compliance monitoring, and accountability. But technology must be matched with enforcement.
If Maharashtra's reforms became a national template, what one addition would you insist on, in regulation, audits or technology, to make them meaningful for patients, especially thalassaemia families who depend on blood banks every fortnight?
For patients who depend on blood regularly, especially people with thalassaemia, reforms must improve safety without disrupting access. My strongest recommendation would be: test, verify, validate, and internalise before mandating at scale.
Frequent changes in policies, portals, formats, and compliance expectations confuse operators and weaken implementation. Patients ultimately bear the cost of that confusion. For thalassaemia families, blood availability, safety, compatibility, timely issue, and continuity are all critical. Technology should strengthen these outcomes, not add avoidable complexity. A meaningful national template should combine three things: a validated technology standard, practical workflow integration, and a clear audit and accountability framework covering the full vein-to-vein chain.
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